Schizophrenia for the Physician Assistant (PA) Licensing Exam
Schizophrenia
- Symptoms:
- Positive Symptoms: Hallucinations (most commonly auditory), delusions, disorganized thinking.
- Negative Symptoms: Emotional flatness, lack of motivation, social withdrawal.
- Cognitive Symptoms: Difficulty focusing, memory problems, impaired executive functions.
- Management:
- Pharmacological: Atypical antipsychotics (e.g., risperidone, olanzapine) are preferred for treatment.
- Supportive Therapies: Cognitive-behavioral therapy, social skills training, and occupational therapy.
- Monitoring: Regular assessment for side effects like metabolic syndrome, extrapyramidal symptoms, and tardive dyskinesia.
Schizophreniform Disorder
- Duration: Symptoms similar to schizophrenia but lasting less than 6 months.
- Treatment: Often treated similarly to schizophrenia, focusing on acute stabilization with medications and monitoring for any progression to schizophrenia.
Brief Psychotic Disorder
- Characteristics: Sudden onset of psychotic symptoms that resolve within a month.
- Management: Typically involves short-term antipsychotic treatment and psychological support, particularly after acute stress.
Schizoaffective Disorder
- Diagnosis: Presence of psychotic symptoms along with significant mood episodes (depressive or manic).
- Treatment:
- Medications: Combination of antipsychotics and mood stabilizers or antidepressants.
- Holistic Care: Integration of psychiatric and psychosocial interventions.
Delusional Disorder
- Symptoms: Persistent delusions without the full spectrum of psychotic symptoms.
- Management:
- Antipsychotics: Used cautiously due to varied response.
- Psychotherapy: Important for managing distress and possibly modifying delusional beliefs.
Shared Psychotic Disorder (Folie à Deux)
- Presentation: Psychotic symptoms, especially delusions, shared between two closely related individuals.
- Intervention:
- Treatment focuses on separating the involved individuals and addressing each person’s delusional content individually.
Commonly Tested Items
- Diagnostic Criteria: Understanding DSM-5 criteria for each disorder and differentiating between them.
- Pharmacological Management: Knowing first-line treatments, side effects, and monitoring requirements of antipsychotic medications.
- Non-pharmacological Interventions: Role of psychotherapy, community support programs, and rehabilitation in managing these disorders.
- Legal and Ethical Considerations: Handling consent, confidentiality, and treatment decisions, especially in acutely unstable patients.